Inducing tricuspid regurgitation as palliation

Schroeder, James K.; Wiggins, James W.

doi:10.1007/bf00798217

Cited by 3 publications

(1 citation statement)

References 4 publications

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“…Right ventricular decompression, either by valvotomy or avulsion or excision of the tricuspid valve. 8,9,13,14,16,[18][19][20][21][23][24][25][26][27][28][30][31][32][33]39,55,83,[103][104][105] Temporary occlusion of the right ventricle with a balloon. 81,82 Thromboexclusion of the right ventricle.…”

Section: The Right Ventricular-dependent Coronary Arterial Circulationmentioning

confidence: 99%

The significance of ventriculo-coronary arterial connections in the setting of pulmonary atresia with an intact ventricular septum

2005

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Section: The Right Ventricular-dependent Coronary Arterial Circulationmentioning

confidence: 99%

The significance of ventriculo-coronary arterial connections in the setting of pulmonary atresia with an intact ventricular septum

2005

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The echocardiographic assessment of pulmonary atresia with intact ventricular septum

Kleinman

2006

Cathet Cardio Intervent

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The Transcatheter Management of the Neonate and Infant with Pulmonary Atresia and Intact Ventricular Septum

Cheatham

1998

J Interven Cardiology

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The optimal management of the neonate and infant with pulmonary atresia (PA) and intact ventricular septum (IVS) remains controversial. The ultimate aim of any treatment algorithm is to achieve a four-chambered, biventricular, completely separated circulation. In 1991, transcatheter perfor ation of the atretic membrane followed by successful balloon valvuloplasv was reported using a laser-assisted guidewire in the United Kingdom and the stiffeizd of a guidewire in the United States. The following year, a radiofrequency (RF) guidewire was successfully used, while stenting of the ductus arteriosus to maintain adequate pulmonary blood was also reported. Most recently, a steerable 5 Fr RF catheter was used to "burn '' the atretic membrane. From a series of 15 publications, a total of 69 neonates underwent attempted pulmonary valve perforation: I7 laser guidewire, 28 RF guidewire, 25 stiff end guidewire, and I steerable RF catheter. Successful perforation by technique was: 82.4% laser, 88.5% RF. 68% stiff end, and 100% steerable RF. The accumulative success rate was 79.7%, mortality 4.3%. major complication 18%, and need for additional pulmonary blood 48%. Follow-up thus far has been encouraging. The technique of transcatheter pegoration of the atretic pulmonary valve membrane is demanding and not without risk. but in experienced hands can be successful nearly 90% of the time using the RF guidewire. RF energy is commonly used for other cardiac problems and has inherent cost and availability advantages over laser energy. Since nearly 50% of the neonates still require additional pulmonary bloodflow, the interventionalist must be capable and ready to stent the PDA, or send to surgery. The neonate with right ventricular (RV) dominant coronary circulation remains a high risk group. However, careful cardiac catheterization with temporary transcatheter RV decompression may lead to a better understanding of this complex physiology. (J Interven Cardiol 1998;ll 363-387) General Background: Pulmonary Atresia and Intact Ventricular SeptumRobert Freedom reminds us that babies born with pulmonary atresia (PA) and intact ventricular septum (IVS) present a major challenge to the pediatric cardiology and cardiothoracic team.' While we have made significant advances in the treatment of newborns with transposition of the great arteries, even those with hypoplastic left heart syndrome, the outlook for the neonate with underdeveloped right-sided cardiac structures associated with an atretic pulmonary valve remains p~o r .~,~ The designation of "pulmonary atresia with intact ventricular septum" focuses on the outlet of the heart, and thus there has been an inherent suggestion of "simplicity" to this disorder. However, as we all know, nothing could be further from the truth!' This disorder is characterized by a striking heterogenicity of the right ventricle, its inlet, and its functionalIn addition, a number of these patients have hemodynamically important ventriculocoronary connections between the right ventricle and subepicardial coronary...

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Inducing tricuspid regurgitation as palliation

Abstract: We describe a technique for palliative decompression of the hypertensive right ventricle seen in pulmonary atresia with intact ventricular septum (PAIVS), utilizing a bioptome catheter for partial tricuspid avulsion.

Cited by 3 publications

References 4 publications

The significance of ventriculo-coronary arterial connections in the setting of pulmonary atresia with an intact ventricular septum

The significance of ventriculo-coronary arterial connections in the setting of pulmonary atresia with an intact ventricular septum

The echocardiographic assessment of pulmonary atresia with intact ventricular septum

The Transcatheter Management of the Neonate and Infant with Pulmonary Atresia and Intact Ventricular Septum

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